The Grand Rapids Clinical Oncology Program, a pioneer in the development of community-based cancer control research and clinical trial programs, is submitting this continuation application. It has developed unusually strong multidisciplinary task forces for the development and interpretation of future treatment protocols and integrated studies of cancer control and is committing itself to a very strong showing of accruals for the coming year. The GRCOP is a consortium of six acute care hospitals with 1778 aggregate beds. The total service area population is about 1.2 million, and consortium members compose 42.2% of all hospital beds in the 12 county western Michigan area. All oncology services for the city of Grand Rapids (almost half the population base) are provided by five of the GRCOP's component hospitals. Within the health service area, only two oncologists are not members of the CCOP. The area has an estimated 4200 new diagnoses of cancer annually, of which GRCOP component hospitals registered 3280, or about 75%. Formed in 1975, GRCOP was one of the six original COP grantees. It has expanded its affiliations and added capabilities for enhanced participation in cancer control outreach as well as therapeutic research studies. It is served by a population-based cancer registry and joint IRB, as well as centralized quality control, leadership, operations, and data management support. GRCOP has been the model organization structure for other CCOPS around the country. In this renewal application, physicians from 27 practices in four cities demonstrate their cohesiveness as active co-investigators. They are making renewed commitments to community participation and enhanced protocol accrual. The community has committed $290,000 in support of the program. The GRCOP's national research bases continue to be SWOG and NSABP, with the addition of M.D. Anderson Hospital and Tumor Institute as a cancer control research base. Over the past three years, The GRCOP accrued 240 patients to protocols of the SWOG, NSABP, RTOG, and CCCMD; there were 55 referrals to 15 research institutions involved in NCI sponsored clinical trials. The GRCOP has had a steady increase in accruals and a continued low cost for patient accrual. During the NCI's suggested three month period, GRCOP investigators accrued 20 patients to treatment protocols. For the coming year, GRCOP projects 102.40 accrual credits for treatment protocols and 207.35 for cancer control.